Effects of Dietary Factors on Gout: A Systematic Review

Authors

Obi Olor P

University of Education and Entrepreneurship University of Education and Entrepreneurship (Nigeria)

Ishiekwen Bridget Ushang

University of Education and Entrepreneurship University of Education and Entrepreneurship (Nigeria)

Article Information

DOI: 10.51244/IJRSI.2025.1210000203

Subject Category: Health

Volume/Issue: 12/10 | Page No: 2294-2308

Publication Timeline

Submitted: 2025-10-20

Accepted: 2025-10-28

Published: 2025-11-15

Abstract

Recent studies reveal that in spite of the increase in the prevalence of gout, the role of dietary risk factors in the development and management of this condition remains unclear.
Therefore, this review work aimed at clarifying the role of dietary factors in the risk and management of gout.
An extensive search of literatures published between 1960, to 2018 was performed on the databases of PubMed, CINAHL, Science direct, Cochrane, BMJ, Ann Rheum Dis, and BioMed to identify relevant Cohort, Prospective, and Population based, or Cross-sectional studies that examined the effect of diet on gout.
A total of 19 studies (2 Cohort studies, 5 Prospective studies, 1 Population based studies, and 11 Cross sectional studies) were included in this review work. And the methodological quality of these studies was evaluated using the quality assessment tool for observational and cross-sectional studies developed by the National Heart, Lungs and Blood Institute.
This work revealed that a positive association exist between intake of sugar sweetened beverages and the risk of gout. It also revealed an inverse relationship between the increase in coffee consumption and the risk of gout. The multivariate relative risk (RR) for incident gout based on coffee intake grouping of 0, <1, 1 - 3, 4 - 5, and > 6 cups per day, were 1.00, 0.97, 0.92, 0.60 (95% confidence interval 0.41 - 0.87), and 0.41 (95% confidence interval 0.19 - 0.88), respectively (P for trend is equal to 0.009).
In addition, this work also recorded a positive association between risk of gout and the consumption of either meat or sea food. The multivariate relative risk of gout among participants who consumed meat at a mean daily intake of 2.5 servings per day was recorded as 1.41 (95% CI, 1.07 to 1.86; P for trend = 0.02).
In summary, this research successfully clarified the role of dietary factors in both the risk and the management of gout. It also showed that while the consumption of sugar-sweetened beverages, purine - rich foods (like meat and seafood), and fructose rich fruits increased the risk for gout, the consumption of coffee and dairy products reduced the risk for gout. Therefore, it is safe to suggest that dietary risk factors should be considered when gout patients are being managed.

Keywords

Gout, Arthritis, Dietary factors, sugar-sweetened beverages, purine - rich foods fructose rich fruits

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References

1. Bae J, Park PS, Chun BY, Choi BY, Kim MK, Shin MH, Lee YH, Shin DH, Kim SK (2015). The effect of coffee, tea, and caffeine consumption on serum uric acid and the risk of hyperuricemia in Korean MultiRural Communities Cohort. Rheumatol Int. 2015 Feb;35(2):327-36. doi: 10.1007/s00296-014-3061-8. Epub 2014 Jun 15. [Google Scholar] [Crossref]

2. Batt C, Phipps-Green AJ, Black MA, et al (2013). Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout. Ann Rheum Dis. 2014; 73:2101–2106. [PubMed: 24026676] [Google Scholar] [Crossref]

3. Bhole V, de Vera M, Rahman MM, Krishnan E, Choi H. Epidemiology of gout in women: Fifty two-year follow-up of a prospective cohort. Arthritis Rheum. 2010; 62(4):1069–1076. [PubMed: 20131266] [Google Scholar] [Crossref]

4. Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. Am J Med 1987;82:421–6 [Google Scholar] [Crossref]

5. Chandratre, Rhoddy, Clarson et al (2013). Health-related quality of life in gout: A systematic review. Rheumatology 52 (11), 20131-2040, 2013. [PubMed] [Google Scholar] [Crossref]

6. Choi HK. (2010). A prescription for lifestyle change in patients with hyperuricemia and gout. Curr Opin Rheumatol. 2010; 22(2):165–172. [PubMed: 20035225] [Google Scholar] [Crossref]

7. Choi HK, Atkinson K, Karlson EW, et al. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004; 363:1277–1281. [PubMed: 15094272] [Google Scholar] [Crossref]

8. Choi HK, Curhan G. (2010). Coffee consumption and risk of incident gout in women: the Nurses' Health Study. Am J Clin Nutr. 2010 [Google Scholar] [Crossref]

9. Choi HK, Curhan G. (2007). Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey. Arthritis Rheum. 2007 Jun 15;57(5):816-21. PMID:17530681 DOI:10.1002/art.22762 [Google Scholar] [Crossref]

10. Choi HK, Willett W, Curhan G. (2007). Coffee consumption and risk of incident gout in men: a prospective study. Arthritis Rheum. 2007; 56(6):2049–2055. [PubMed: 17530645] [Google Scholar] [Crossref]

11. Choi HK, Willett W, Curhan G. (2010). Fructose-rich beverages and risk of gout in women. JAMA. 2010;304:2270–8. [Google Scholar] [Crossref]

12. Choi HK, Curhan G. (2007). Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007; 116(8):894–900. [PubMed: 17698728] [Google Scholar] [Crossref]

13. Choi HK, Atkinson K, Karlson EW, Curhan G. (2005). Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals’ follow-up study. Arch Intern Med 2005;165:742–8 [Google Scholar] [Crossref]

14. Choi HK, Mount DB, Reginato AM. (2005). Pathogenesis of gout. Ann Intern Med 2005;143:499–516. [Google Scholar] [Crossref]

15. Choi HK, Ford ES, Li C, Curhan G. (2007). Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2007;57:109–15 [Google Scholar] [Crossref]

16. Choi HK, Atkinson K, Karlson EW, Willett W and Curhan G. (2004). Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004; 350:1093–1103. [PubMed: 15014182] [Google Scholar] [Crossref]

17. Choi JW, Ford ES, Gao X, et al. (2008). Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis and rheumatism. 2008; 59:109–116. [PubMed: 18163396] [Google Scholar] [Crossref]

18. Choi HK, Curhan G. (2008). Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008; 336(7639):309–312. [PubMed: 18244959] [Google Scholar] [Crossref]

19. Clifford AJ, Riumallo JA, Young VR, Scrimshaw NS. (1976). Effect of oral purines on serum and urinary uric acid of normal, hyperuricemic and gouty humans. J Nutr 1976; 106:428-34. [Google Scholar] [Crossref]

20. Clifford AJ, & Story DL. (1976). Levels of purines in foods and their metabolic effects in rats. J Nutr 1976; 106:435-42. [Google Scholar] [Crossref]

21. Currie WJ. (1979). Prevalence and incidence of the diagnosis of gout in Great Britain. Ann Rheum Dis 1979; 38:101–6. [Google Scholar] [Crossref]

22. Emmerson BT. (1996). The management of gout. N Engl J Med 1996; 334:445-51. [Google Scholar] [Crossref]

23. Fam AG. (2002). Gout, diet, and the insulin resistance syndrome. J Rheumatol 2002; 29:1350-5. [Google Scholar] [Crossref]

24. Gao X, Qi L, Qiao N, Choi HK, Curhan G, Tucker KL, Ascherio A. (2007). Intake of added sugar and sugar-sweetened drink and serum uric acid concentration in US men and women. Hypertension. 2007 [Google Scholar] [Crossref]

25. Aug;50(2):306-12. Epub 2007 Jun 25. PMID:17592072 [Google Scholar] [Crossref]

26. DOI:10.1161/HYPERTENSIONAHA.107.091041 [Google Scholar] [Crossref]

27. Harris CM, Lloyd DC, Lewis J. (1995). The prevalence and prophylaxis of gout in England. J Clin Epidemiol. 1995; 48(9):1153–1158. [PubMed: 7636517] [Google Scholar] [Crossref]

28. Hyon K. C, Walter W, Gary C. (2007). Fructose-Rich Beverages and the Risk of Gout in Women. JAMA. 2010 November 24; 304(20): 2270–2278. doi:10.1001/jama.2010.1638. [Google Scholar] [Crossref]

29. Hyon KC and Gary C. (2007). Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. doi:10.1136/bmj.39449.819271.BE [Google Scholar] [Crossref]

30. Joacim ML, Edgar DG, Susana CR, Victor GG, Juan OT, Berenice RP, Gerardo GHB, Margarita CR, Manuel QT, Samantha ER, and Jorge S (2014). Sweetened beverage consumption and the risk of hyperuricemia in Mexican adults: a cross-sectional study. BMC Public Health. 2014; 14: 445. Published online 2014 May 12. doi: 10.1186/1471-2458-14-445 PMCID: PMC4024276 PMID: 24884821 [Google Scholar] [Crossref]

31. Kiyohara C, Kono S, Honjo S, Todoroki I, Sakurai Y, Nishiwaki M, et al. (1999). Inverse association between coffee drinking and serum uric acid concentrations in middle-aged Japanese males. Br JNutr. 1999; 82(2):125–130. [PubMed: 10743484] [Google Scholar] [Crossref]

32. Klemp P, Stansfield SA, Castle B, Robertson MC (1997). Gout is on the increase in New Zealand. Ann Rheum Dis. 1997; 56(1):22–26. [PubMed: 9059136] [Google Scholar] [Crossref]

33. Lawrence RC, Felson DT, Helmick CG, et al. (2007). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum. Dec 28; 2007 58(1):26–35. [PubMed: 18163497] [Google Scholar] [Crossref]

34. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH et al (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheumatol 41:778–799 [Google Scholar] [Crossref]

35. Li X, Song P, Li J, Wang P, Li G (2015). Relationship between hyperuricemia and dietary risk factors in Chinese adults: a cross-sectional study. Rheumatol Int. 2015 Dec;35(12):2079-89. doi: 10.1007/s00296015-3315-0. Epub 2015 Jul 5. [Google Scholar] [Crossref]

36. McCarty DJ, Hollander JL: Identification of urate crystals in gouty synovial fluid. Ann Intern Med 1961, 54:452-460. [Google Scholar] [Crossref]

37. Merriman TR & Dalbeth, (2011). An update on the genetic architecture of hyperuricemia and gout. Arthritis research & therapy. 2015; 17:98. [PubMed: 25889045] [Google Scholar] [Crossref]

38. Mikuls TR, Farrar JT, Bilker WB, Fernandes S, Schumacher HR Jr, Saag KG. Gout epidemiology: results from the UK General Practice Research Database, 1990–1999. Ann Rheum Dis 2005;64:267–72 [Google Scholar] [Crossref]

39. Nathalie B and Alexander S., (2010). Mechanisms of Inflammation in Gout. Arthritis Research & Therapy 2010, 12:206 http://arthritis-research.com/content/12/2/206 doi:10.1186/ar2952 [Google Scholar] [Crossref]

40. National Center for Health Statistics. Lab methods NHANES 1999 –2002. Available at: http://www.cdc.gov/nchs/data/nhanes/nhanes_01_02/l40_b_met_uric_acid.pdf. Accessed December 2006 [Google Scholar] [Crossref]

41. Nuki G & Simkin PA. (2009). A concise history of gout and hyperuricemia and their treatment. Feb. 2006 Arthritis research & therapy8 suppl 1(suppl 1): S1 DOI:10.1186/ar1906 [PubMed] [Google Scholar] [Crossref]

42. Obi O. P & Ishiekwen B. U (2024). A Critical Review of the Cardio-Protective Potential of Diets and Foods Rich in Soluble Fibre Family and Consumer Sciences Society of Nigeria (FACSSON) Vol 4 [Google Scholar] [Crossref]

43. Obi O. P, & James E. A (2024). Water-soluble Dietary Fibers and Cardiovascular Diseases: A Comprehensive Review Contemporary Research and Perspectives in Biological Science Vol. 4, Pages 115 BP International [Google Scholar] [Crossref]

44. Roddy E & Doherty M (2010). Gout. Epidemiology of gout. Arthritis research & therapy 12, (223), 2010 [BioMed]. [Google Scholar] [Crossref]

45. Roddy E, Mallen CD, Hider SL & Jordan KP (2010). Prescription and comorbidity screening following consultation for acute gout in primary care. Rheumatology (Oxford). 2010 Jan;49(1):105-11. [PubMed] [Google Scholar] [Crossref]

46. Roubenoff R, Klag MJ, Mead LA, Liang KY, Seidler AJ, Hochberg MC. (1991). Incidence and risk factors for gout in white men. JAMA. 1991; 266(21):3004–3007. [PubMed: 1820473] [Google Scholar] [Crossref]

47. Stein HB, Hasan A, Fox IH. Ascorbic acid-induced uricosuria. A consequency of megavitamin therapy. Ann Intern Med 1976;84:385–388. [PubMed: 1259282] [Google Scholar] [Crossref]

48. Tang D, Xia B. (1998). Influence of dietary habits and body weight on blood uric acid in the elderly. PMID:10682557. Hunan Yi Ke Da Xue Xue Bao. 1998;23(5):447-9. [Google Scholar] [Crossref]

49. Teng GG, Tan CS, Santosa A, Saag KG, Yuan JM, Koh WP. (2013). Serum urate levels and consumption of common beverages and alcohol among Chinese in Singapore. Arthritis Care Res (Hoboken). 2013 [Google Scholar] [Crossref]

50. Sep;65(9):1432-40. doi: 10.1002/acr.21999. PMID:23463601 PMCID:PMC3710722 [Google Scholar] [Crossref]

51. Vitart V, Igor R, Caroline H, Nicola KG et al (2008). SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout. Nature genetics 40 (4), 437, 2008. [PubMed]. [Google Scholar] [Crossref]

52. Wallace KL, Riedel AA, Joseph-Ridge N, Wortmann R. Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population. J Rheumatol 2004; 31:1582–7 [Google Scholar] [Crossref]

53. Young H.R, Yanyan Z & Hyon K.C (2012). The Epidemiology of Uric Acid and Fructose. Semin Nephrol. 2011 September; 31(5): 410–419. doi: 10.1016/j.semnephrol.2011.08.004. [Google Scholar] [Crossref]

54. Zagar L, Theodoratou E, Kyle J, Farrington SM, Agakov F, Tenesa A, Walker M, McNeill G, Wright AF, Rudan I, Dunlop MG, Campbell H. (2012). The association of dietary intake of purine-rich vegetables, sugar-sweetened beverages and dairy with plasma urate, in a cross-sectional study. PLoS One. 2012;7(6):e38123. doi: 10.1371/journal.pone.0038123. Epub 2012 Jun 6. [Google Scholar] [Crossref]

55. Zhu Y, Pandya BJ, Choi HK (2011). Prevalence of gout and hyperuricemia in the US general population: [Google Scholar] [Crossref]

56. the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum 63:3136–3141 [Google Scholar] [Crossref]

57. Zollner N, Griebsch A. (1974). Diet and gout. Adv Exp Med Biol 1974; 41:435-42. [Google Scholar] [Crossref]

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